Planned vaginal delivery or planned caesarean delivery in women with extreme obesity

Homer, CSE; Kurinczuk, JJ; Spark, P; Brocklehurst, P; Knight, M

Planned vaginal delivery or planned caesarean delivery in women with extreme obesity

Homer, CSE

Kurinczuk, JJ Spark, P Brocklehurst, P Knight, M

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Publication Type:: Journal Article
Citation:: BJOG: An International Journal of Obstetrics and Gynaecology, 2011, 118 (4), pp. 480 - 486
Issue Date:: 2011-03-01

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Field	Value	Language
dc.contributor.author	Homer, CSE https://orcid.org/0000-0002-7454-3011	en_US
dc.contributor.author	Kurinczuk, JJ	en_US
dc.contributor.author	Spark, P	en_US
dc.contributor.author	Brocklehurst, P	en_US
dc.contributor.author	Knight, M	en_US
dc.date.issued	2011-03-01	en_US
dc.identifier.citation	BJOG: An International Journal of Obstetrics and Gynaecology, 2011, 118 (4), pp. 480 - 486	en_US
dc.identifier.issn	1470-0328	en_US
dc.identifier.uri	http://hdl.handle.net/10453/18586
dc.description.abstract	Objective To compare the outcomes of planned vaginal versus planned caesarean delivery in a cohort of extremely obese women (body mass index ≤ 50 kg/m2). Design A national cohort study using the UK Obstetric Surveillance System (UKOSS). Setting All hospitals with consultant-led maternity units in the UK. Population Five hundred and ninety-one extremely obese women delivering in the UK between September 2007 and August 2008. Methods Prospective cohort identification through UKOSS routine monthly mailings. Main outcome measures Anaesthetic, postnatal and neonatal complication rates. Results After adjustment, there were no significant differences in anaesthetic, postnatal or neonatal complications between women with planned vaginal delivery and planned caesarean delivery, with the exception of shoulder dystocia (3% versus 0%, P = 0.019). There were no significant differences in any outcomes in the subgroup of women who had no identified medical or antenatal complications. Conclusions This study does not provide evidence to support a routine policy of caesarean delivery for extremely obese women on the basis of concern about higher rates of delivery complications, but does support a policy of individualised decision-making on the mode of delivery based on a thorough assessment of potential risk factors for poor delivery outcomes. © RCOG 2011 BJOG An International Journal of Obstetrics and Gynaecology.	en_US
dc.relation.ispartof	BJOG: An International Journal of Obstetrics and Gynaecology	en_US
dc.relation.isbasedon	10.1111/j.1471-0528.2010.02832.x	en_US
dc.subject.classification	Obstetrics & Reproductive Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Pregnancy Complications	en_US
dc.subject.mesh	Obesity	en_US
dc.subject.mesh	Pregnancy Outcome	en_US
dc.subject.mesh	Prenatal Care	en_US
dc.subject.mesh	Delivery, Obstetric	en_US
dc.subject.mesh	Cesarean Section	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Patient Care Planning	en_US
dc.subject.mesh	Female	en_US
dc.title	Planned vaginal delivery or planned caesarean delivery in women with extreme obesity	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	118	en_US
utslib.for	1110 Nursing	en_US
utslib.for	11 Medical and Health Sciences	en_US
dc.location.activity	Canberra, Australia
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
utslib.copyright.status	open_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	118	en_US

Abstract:

Objective To compare the outcomes of planned vaginal versus planned caesarean delivery in a cohort of extremely obese women (body mass index ≤ 50 kg/m2). Design A national cohort study using the UK Obstetric Surveillance System (UKOSS). Setting All hospitals with consultant-led maternity units in the UK. Population Five hundred and ninety-one extremely obese women delivering in the UK between September 2007 and August 2008. Methods Prospective cohort identification through UKOSS routine monthly mailings. Main outcome measures Anaesthetic, postnatal and neonatal complication rates. Results After adjustment, there were no significant differences in anaesthetic, postnatal or neonatal complications between women with planned vaginal delivery and planned caesarean delivery, with the exception of shoulder dystocia (3% versus 0%, P = 0.019). There were no significant differences in any outcomes in the subgroup of women who had no identified medical or antenatal complications. Conclusions This study does not provide evidence to support a routine policy of caesarean delivery for extremely obese women on the basis of concern about higher rates of delivery complications, but does support a policy of individualised decision-making on the mode of delivery based on a thorough assessment of potential risk factors for poor delivery outcomes. © RCOG 2011 BJOG An International Journal of Obstetrics and Gynaecology.

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http://hdl.handle.net/10453/18586